Medical therapy for bleeding peptic ulcer

Ranjeev, P. and Goh, Khean Lee (2000) Medical therapy for bleeding peptic ulcer. Journal of the University of Malaya Medical Centre (JUMMEC), 5 (2). pp. 67-72. ISSN 1823-7339,

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The majority of patients with upper gastrointestinal bleeding due to peptic ulcers stop bleeding spontaneously. The remainder of patients who have persistent or recurrent bleeding will require surgical or endoscopic intervention. Medical therapy provides an attractive alternative to these two treatment options. The advent of H2 antagonists in the mid 1970s revolutionized the treatment of peptic ulcer disease as it provided good ulcer healing with a treatment course of 6-8 weeks. A more potent acid suppressing class of drugs: the proton-pump inhibitors (PPl's) were introduced in the late 1980s and provided even better and faster ulcer healing. It was natural that the acid suppressing drugs were also used for the treatment of ulcer bleeding. Intravenous H2 antagonist and more recently intravenous PPI's have routinely been prescribed in many hospitals as soon as a bleeding patient is admitted. Critical evaluation of the literature shows, however, that H2 antagonists are no more effective than placebo in stopping ulcer bleeding. The PPI's, on the other hand, have been shown in several clinical studies to have a beneficial effect. The action of acid suppression in stopping ulcer bleeding is believed to be due to its effect in the stabilization of an ulcer clot by providing a high pH milieu and to commence the process of ulcer healing.

Item Type: Article
Additional Information: DH
Uncontrolled Keywords: Upper gastrointestinal bleed(UGIB); Proton pump inhibitors(PPIs); H2 antagonists
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Mr Jasny Razali
Date Deposited: 20 Jul 2020 02:43
Last Modified: 20 Jul 2020 02:43

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